Sunday, May 12, 2013

Will You Qualify for Long Term Care Insurance?

A few years ago, when I was in my late 50's and my husband was in his early 60's, we were fortunate enough to be able to purchase Long Term Care Insurance for both of us.  Even though we were healthy at the time, it was still not easy to obtain.  The first company where we applied accepted me, but not my husband.  Disappointed, we consulted with an insurance broker and, on our second attempt, we were both accepted.

Most people are somewhere between the ages of 50 and 75 before they realize that owning LTC insurance could be beneficial.  By that time, it may be too late for many of them to be accepted.  According to the American Association for Long-Term Care Insurance, only about 51% of applicants qualify in their 50's, 42% in their 60's, and 24% in their 70's.  This means that far fewer than half of all people over the age of 50 would be accepted if they applied. If you have tried to get LTC insurance in the past and been turned down, you are definitely not alone.

In fact, the website for this organization has a list of conditions that they say will make it nearly impossible for you to qualify for this insurance.  They are pretty blunt on their site.  They tell you not to even bother to fill out an application if you currently use a walker, wheelchair, crutches, a multi-pronged cane, or need oxygen.

That's just the beginning.  They also say that "it generally won't pay to take the time to request a quote" if you already require assistance with dressing, bathing, feeding or other areas of daily care, including help with grocery shopping, the use of a telephone or the use of transportation. (I wonder if getting confused by a "smartphone" would disqualify someone from LTC insurance?  Better not mention it!)

In addition, they also tell you not to fill out the form if you have a history of certain illnesses.

Illnesses That Automatically Disqualify You for LTC Insurance

Alzheimer's or other types of dementia or memory loss
Cystic Fibrosis
Kidney Failure
Cirrhosis of the Liver
Multiple Sclerosis
Muscular Dystrophy
Post-Polio Syndrome
Sickle Cell Anemia
Systemic Lupus Erythematosus

At the end of this list of illnesses they also say on their site, "If you are not insurable, then we are truly sorry."  Of course, this is small consolation for the more than 50 percent of Baby Boomers who do not qualify for this insurance.

If you do not have any of the illnesses or health problems listed above, it is highly recommended by most retirement planners that you purchase the insurance at the earliest possible time, while you are young enough and healthy enough to qualify, and while you can still get the lowest possible premium.

Other Health Conditions That May Disqualify You

On the other hand, just because you do not have one of the health conditions that was listed above, you are not guaranteed to be accepted.  I have also known people who had problems obtaining LTC insurance because they had diabetes, a history of heart problems, or because they had been treated for cancer.  Since these illnesses are not specifically mentioned on the above list, it may be that each carrier of LTC insurance has difference standards regarding these health issues.  In addition, it may also depend on other factors, such as how long ago the cancer was treated, or the severity of the cardiac problems.

Best Time to Buy LTC Insurance   

The ideal time to purchase LTC insurance is when you are young and healthy, before you have been diagnosed with a serious disease.  However, how many healthy young adults in their 20's, 30's and 40's are thinking about how they will pay for their nursing home or personal care when they become old and frail?  Unfortunately, very few think about it.

In my next post, "Alternatives to Long Term Care Insurance," we will discuss some of the options that are available for people who become incapacitated in their later years and do not have LTC Insurance.

If you are interested in reading more about planning for your retirement years, you may want to look through the index articles listed below.  Each one contains some general information plus links to a number of articles on that topic:

Gifts, Travel and Family Relationships

Great Places for Boomers to Retire Overseas

Great Places to Retire in the United States

Health and Medical Topics for Baby Boomers

Money and Financial Planning for Baby Boomers

You are reading from the blog:

Photo of elderly man courtesy of



  1. This is an excellent and very important message. A home nurse came to give me my exam for long term health care insurance and we had discussions about the criteria different companies use. While it's very important to some companies, I was surprised to learn the company I chose had no interest at all in whether I exercise regularly! Hard to believe.

  2. Thank you for sharing the fact that different insurance companies have different criteria regarding who they will accept. It is interesting that your company does not care whether or not you get exercise. You would think that would be an important factor in maintaining good health and staying out of a nursing home!

  3. When people ask what is long term care insurance, it often follows that they also ask how one files a claim for it. In order to file a claim and start receiving benefits, the person only needs to be incapable of doing two of the six activities of daily living: eating, toileting, bathing, dressing, transferring, and continence.

  4. A long-term care insurance policy helps you pay a portion of the cost for the long-term care services you may need someday. And that can allow you to stay connected to the things that matter most – your family, your home and your nest egg.


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